Learning objectives
1.
To describe normal esophageal findings on fluoroscopy
2.
To review the most common causes of esophageal dysphagia and describe their fluoroscopic findings
Background
Dysphagia describes a subjective awareness of swallowing difficulty during the passage of a bolus from the mouth to the stomach or the perception of obstruction during swallowing.
It suggests the presence of an organic abnormality in the passage of solids or liquids from the oral cavity to the stomach.
It is a common clinical problem and its prevalence is increasing,
afecting 13.5% of the general population.
It is also an alarm symptom that warrants immediate evaluation to define the exact cause and initiate appropriate therapy....
Findings and procedure details
Normal Findings
Esophagography provides not only anatomic but also functional information about the pharynx,
esophagus,
gastroesophageal junction (GEJ) and gastric cardia.
It allows the evaluation of esophageal motility and assessment for gastroesophageal reflux.
Usually a moderately low-density barium suspension is used.
Whenever there is a suspected perforation,
a water-soluble contrast should be used,
as ithas no deleterious effects on the mediastinum or peritoneal cavity.
Two to five individual swallows should be observed as the bolus passes.
An individual swallow should be evaluated at a time,...
Conclusion
Barium swallow tests are still an important imaging modality to evaluate esophageal morphology and function,
allowing the evaluation of esophageal motility and also the assessment for gastroesophageal reflux.
One should be aware most common causes of esophageal dysphagia and their usual fluoroscopic findings,
so that a diagnosis can be made.
References
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Practical Alimentary Tract Radiology.
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Levine M et al (2012).
Practical Fluoroscopy of the GI and GU Tracts.
Cambridge: Cambridge University Press
Carurri L,
Turnner M (2015).
Dysphagia Revisited: Common and Unusual Causes.
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Levine M (2008).
Barium Esophagography: A Study for All Seasons.
Clinical Gastroenterology And Hepatology; 6: 11–25
Levine M,
Rubesin S (2005).
Diseases of the...